The present invention relates to the area of plastic surgery and, more particularly, to a facial implant usable in reconstructive and cosmetic surgery of the sub-malar region of the face, said implant usable, in addition to other uses, as a maxillary bone prosthesis.
Facial surgery involves the reconstruction of cutaneous tissue, particularly about the face, which is performed to correct defects resulting from either trauma, disease, or the normal marks of time. More particularly, facial plastic surgery, as commonly known today, is employed to improve the shape and contour of particular portion of the face. More particularly, this need is a consequence of the increased prominence of the nasal labial folds, which prominence occurs with the aging process. This phenomena is caused by attenuation of the so called SMAS fibers and surrounding supporting structures of the facial musculature which insert into the nasal labial fold at the level of the dermis. Also contributing to the prominence of the nasal labial folds is the lack of tone of the overlying facial skin, which also descends with the aging process. Finally, the fatty thickness of the skin and subcutaneous tissue in this area also atrophy as the aging process advances.
All of the above set forth conditions contribute to reduction in soft tissue thickness and a loss of tone of the skin in the nasal labial area of the face. This region is referred to by plastic surgeons as the central lower third of the face. The final result of all three of the above processes is that of a sunken, tired look around the mouth and above the upper lip area.
Historically, the above has been an extremely difficult problem to correct, even with state-of-the-art face-lifting procedures. Past corrective attempts have included SAMS plcication, deep plane rhytidectomy, direct excision of the overlying folds and multiple injection therapies of materials including otologous fat, silicone and collagen.
The instant invention resulted from the discovery that aesthetic improvement of the nasal labial folds can be accomplished by augmentation of the underlying bony structures in this area that is, of the nasal maxillary bone junctions. Such augmentation of this area operates to elevate the overlying SAMS fibers and subcutaneous tissues anteriorly. This procedure has the effecti of stretching the overlying subcutaneous skin or soft tissue as well as the overlying SAMS fibers by increasing the convex outer surface of the underlying bony skeleton with a resultant restoration of the fullness of the atrophied overlying subcutaneous tissues, this bringing about an overall more youthful look in this area.
In the prior art it is known to augment the human chin as is reflected in U.S. Pat. No. 4,344,191 (1982) to Wagner, and in my own U.S. Pat. No. 4,888,018 (1989).
Also, augmentation of the mid-facial maxilla, the mid-face zygoma and mid-face zygomatic arch, are known as is taught in my U.S. Pat. Nos. D.D. 890,877, 290,878, and 290,879.
Implants are also known which provides support to the orbital rim of the eye in the area of the zygomatic arch, as is taught in U.S. Pat. No. 4,790,849 (1988) to Terino, which implant is shown in the illustration of the prior art which is FIG. 1 of the Drawings. The teaching of said reference to Terino differs from that of the instant invention in that its utility is in connection with intraoral procedures, blepharophasty, and other procedures of the orbit and maxilla, whereas the instant invention, as set forth below, is concerned with procedures of an intraoral nature directed to surgery of the pyriform aperture and, as above described, of the nasal labial folds and nasal maxillary junction. Also, the underlying purpose of Terino is that of raising cheeks in the area of the zygomatic arch to counter the aging process in that area and, as such, is more related to my above reference U.S. Pat. No. D.D. 290,879 (1987) entitled Mid-Facial Zygomatic An Skeletal Implant. My instant invention has, as its purpose, not the augmentation of the cheeks but, rather, the elevation of subcutaneous tissues and muscles overlying the nasal labial fold area, including the SAMS fibers, and further, enhancement in the areas known as the levator labil superioris, the levator anguli otis, and the levator alae. In short, the purpose of the instant invention is to correct atrophication and thinning of subcutaneous tissue in the nasal labial fold area. Other art known to the inventor includes U.S. Pat. No. 4,969,901 (1990) to Binder entitled Plastic Surgery Implant. Binder, like Terino, is concerned with intraoral device. Further, the device of Binder is intended for use in the sub-malar area, technically known as the canine fossa. Its use requires suturing into a subcutaneous pocket therefore. The structure and method of Binder may be thought of as a different method and structure for achieving a number of the objectives which, in my opinion, are more effectively achieved by the method and structure of my inventive sub-malar facial implant as is set forth herein.